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General NPI Number Information
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NPI Number | 1972627453
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Entity Type | Individual
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Provider Name | ANNA M. STAPLETON M.A.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2048 WASHTENAW RD LOWER LEVEL
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City | YPSILANTI
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State | MI
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Zip | 48197-1889
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Country | US
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Telephone | 734-751-3522
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Fax |
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Provider Business Mailing Address
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Address Line | 45844 SOUTHWICK DR
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City | CANTON
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State | MI
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Zip | 48188-6230
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Country | US
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Telephone | 734-495-9956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301011710
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License Number State | MI
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